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Commentary

Citrullinated proteins: sparks that may ignite the fire in rheumatoid arthritis

Erik R Vossenaar* and Walther J van Venrooij

Author Affiliations

Department of Biochemistry, University of Nijmegen, Nijmegen, The Netherlands

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Arthritis Res Ther 2004, 6:107-111  doi:10.1186/ar1184

Published: 19 April 2004

Abstract

Antibodies directed to citrullinated proteins (e.g. anti-CCP [cyclic citrullinated peptide] antibodies) are highly specific for rheumatoid arthritis (RA). These antibodies are produced at the site of inflammation in RA, and therefore citrullinated antigens are also expected to be present in the inflamed synovium. We discuss literature showing that the presence of citrullinated proteins in the synovium is not specific for RA. The RA-specific antibodies are therefore most likely the result of an abnormal immune response that specifically occurs in RA patients. It was recently shown that presence of anti-CCP antibodies precedes the onset of clinical symptoms of RA by years. It thus appears that it may take years for initial events that cause the generation of anti-CCP antibodies to develop into full-blown disease.

Keywords:
anti-CCP autoantibodies; citrullination; peptidylarginine deiminase; rheumatoid arthritis